HealingWell
Search Close Search
☰

Coming out of flare (hopefully). When to taper?

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/3/2013 11:02 AM (GMT -5)
about 6 weeks ago, I started having my biggest flare since being diagnosed 3 years ago - blood, mucus, gut noises, urgency, D 10x a day. I was on Apriso and Rowasa for flares. My GI switched me from Apriso to Asacol HD (2 6x/day) and had me double up on the Rowasa. I also started taking 2 packets of VSL-3 a day.

Most of my symptoms, which had been going on for a month, subsided in a matter of a week with the new regime. I no longer have blood, mucus or gut noises and I'm usually going 2 times a day in the morning with good formed stools. But some days I don't go at all? and others, like today, I've gone 4x already and the stool quality decreases with each BM (they are less formed). I'm wondering if the flare has subsided and the decreased stool quality is more a function of failing to decrease the rowasa. I was doing it 2x day but it's hard to do in the morning since that's when the BMs come and it's hard to do in the middle of the day because of work. So, I've just been doing it nightly. I have no problems with retention.

Will staying on nightly rowasa after a flare has largely subsided cause looser stool? How do you know when to start tapering? I have the same question regarding when to taper from the Asacol and go back to Apriso. I will of course ask my GI but he's tough to get a hold of sometimes and I wanted to know how others have dealt with this.
Posted 10/3/2013 11:13 AM (GMT -5)
I'm not a rectal med expert so I'm going to dodge that question. Did you always take your Apriso, even when you were doing well? If not that was a big mistake. I'm a little confused as to why you switched to Asacol because you weren't doing well and now you are talking about tapering the Asacol and going back to Apriso. That really doesn't make sense. For the most part, you don't ever taper the oral ASA's. It is important to continue taking them at a dosage large enough to keep you in remission and you should do that forever, even if you have been in remission for 30 years. You never taper completely off of them. Either you weren't taking Apriso at a high enough dosage to keep you in remission or the Apriso quit working for you and if that is the case you should remain on the Asacol and not go back to Apriso at all.
Posted 10/3/2013 11:19 AM (GMT -5)
Since you're alternating between bms and some constipation, you still probably have some inflammation. I'd suggest you stay on the nightly for another 2 weeks, and if all is good, start to taper at every second night.

You could ask the doc about getting back on the Apriso...that would be awesome if you can switch to 4 daily ..but wait till you're stable regarding the rectal meds and you're on maintenance dosage. 

You should taper the oral, dropping by one pill weekly....

Do you have pancolitis?

q

Posted 10/3/2013 11:37 AM (GMT -5)
Thanks Quincy, you have answered some of my other questions in the past and your responses are always helpful and appreciated. I don't have pancolitis; I have left side colitis (18cm up).

Gary, I believe the switch to Asacol was just to put me at a higher does of mesalamine. I did not mean to imply that I plan to come off the drug completely at any time. I just wondered when I could decrease the does by going from 6 Asacol/day (which is about 4800 mg of mesalamine) back to 4 Apriso/day (which is about 1500mg).
✚ New Topic ✚ Reply